Liver, biliary tree and pancrease Flashcards
portal blood flow features
- low hydrostatic pressure
- little resistance to flow
- maximal contact in sinusoids
functions of the liver
- energy metabolism and substrate conversion
- synthesis and secretion of proteins
- solubilizing, transportaiton and storage
- protection and clearance
molecules metabolized by liver
carbohydrates
proteins
lipids
drugs
reactions that protein is metabolized by
oxidative deamination
transamination
dysfunction of protein metabolism disease
hepatic encephalopathy
dysfunction of lipid metabolism disease
steatosis
hyperlipidemia
phase I metabolism reactions
oxidation
hydroxylation
reduction
phase II metabolism reactions
glucuronide
sulfate
glycine
glutathione
proteins synthesized by liver
serum albumin
clotting factors
serum albumin role
- plasma oncotic pressure
- binding protein
protection and clearance functions of liver
- phagocytic and endocytic functions (Kupffer cells)
- ammonia metabolism
- hepatocyte synthesis of glutathione
causes of acute hepatitis
- viral hepatitis
- drugs
- poisons
- toxins
- autoimmune
hep A genome
RNA
hep B genome
DNA
hep A acute or chronic
acute only
hep B acute or chronic
acute and can progress to chronic
hep A results from
direct killing of hepatocytes
hep B results from
attack of host immune system after recognition of viral antigen
hep C genome
RNA
hep C acute or chronic
mostly chronic
most common cause of cirrhosis
hep C
how is alcohol toxic to liver
increases fluidity of biologic membranes, disrupting cellular functions
Wilson’s disease
- copper deposits in eye
- sign of chronic metabolic hepatitis
mechanisms of liver injury
inflammation
fibrosis
cirrhosis (extensive fibrosis)
manifestations of liver dysfunction
- portal hypertension
- clinical presentation (ascites, hypoalbuminemia)
2 outcomes of portal hypertension
- portal-to-systemic shunting
- disorder of renal Na and H20 homeostasis
results of portal-to-systemic shunting
- increased intrahepatic venous pressure
- increased sinusoid pressure
- decreased hepatic filtration
- blood bypasses liver
results of renal Na and H20 homeostasis disorder
- altered intravascular pressure
- increased NO levels
main clinical manifestations of cirrhosis
ascites
hypoalbuminemia
peripheral edema
jaundice
ascites
inappropriate excessive renal retention of Na and thus peritoneal fluid in abdomen
treatment for ascites
diuretics
Na restriction
paracentesis
organs involved in biliary tree
liver
gallbladder
pancreas
duodenum
sequence of biliary tree functions
- absorb Na and water
- liver concentrate bile
- gallbladder stores bile
- bile released
- bile acid delivered to duodenum for digestion
symptoms of gallbladder disease
- episodic RUQ pain
- n/v
symptoms of bile duct obstruction
- jaundice
- pruritus
- dark urine
- acholic stools (pale poop)
two functions of pancreas
- produce digestive fluid/juices to neutralize acidic chyme
- produce hormones
diseases of pancreas
- diabetes
- pancreatic cancer
- acute pancreatitis
- chronic pancreatitis
acute pancreatitis features
- short inflammation
- immune response to tissue necrosis caused by digestive enzymes released from damaged exocrine cells
causes of acute pancreatitis
gallstones
overeating
high alcohol consumption
tissue injury
chronic pancreatitis features
- lasts longer than 3 weeks
- due to irregular fibrosis that replaces endocrine and exocrine cells
causes of chronic pancreatitis
- mostly high alcohol consumption
- acute pancreatitis
symptoms of chronic pancreatitis
insufficient endocrine and exocrine release
